Young men who are overweight or obese are at risk of developing severe liver disease or liver cancer in later life, particularly those who have type 2 diabetes mellitus, according to a new study.
“Interventions to reduce the increasing prevalence of overweight and obesity should be implemented from an early age to reduce the future burden of severe liver disease on individuals and society,” stated the researchers, led by Hannes Hagström, MD, of the Centre for Digestive Diseases at the Karolinska University Hospital in Stockholm. The researchers published their results in Gut.
The researchers noted that men who are overweight in young adulthood should be informed about an increased risk of future severe liver disease, including hepatocellular carcinoma, and that men who develop type 2 diabetes, independent of body mass index (BMI) early in young adulthood or midlife “should be informed of this risk and possibly screened for presence of manifest liver disease to prevent future mortality in liver disease.”
A high BMI is known to increase the risk for future severe liver disease and liver cancer in adults, as well as increases the risk for type 2 diabetes, which in turn raises the risk of severe liver disease.
Previously, researchers had shown that adolescent men with a high BMI have an increased risk of death from end-stage liver disease, even when other factors such as alcohol consumption, smoking, and use of narcotics were taken into account.
Hagström and colleagues conducted a large population-based study of more than 1.2 million Swedish men enlisted for military conscription between 1969 and 1996. The men were followed up from 1 year after conscription. The researchers also linked data on severe liver disease, liver cancer, and type 2 diabetes during follow-up from population-based registers.
During follow-up of more than 34 million person-years, they found 5,281 cases of severe liver disease, including 251 cases of liver cancer. Compared with men of normal weight, overweight men were almost half as likely and obese men more than twice as likely to develop liver disease in later life.
Men with obesity and type 2 diabetes were more than three times more likely to have liver problems when they were older compared with non-diabetic, normal-weight men.
Overall findings about excess risk associated with high BMI were not significantly different after factors such as alcohol consumption and smoking were taken into account, and men who received a diagnosis of alcoholic liver disease during follow-up were excluded from the analysis.
The highest risk of hepatocellular carcinoma was seen in men with a BMI of ≥ 30 kg/m2. This association of a higher BMI with an increased risk of developing hepatocellular carcinoma is consistent with previous studies that found that obesity was associated with increased risks of cirrhosis and hepatocellular carcinoma. The results from the new study “add important information that this increased risk seems to be present from an early age in men,” the researchers concluded.